Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study

Background

It is unclear whether ideal cardiovascular health (
CVH
), and particularly cumulative exposure to ideal
CVH
(cum
CVH
), is associated with incident diabetes. We aimed to fill this research gap.



Methods and Results

The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006–2007 and who were subsequently followed up at 2‐ (Exam 2), 4‐ (Exam 3), and 6 (Exam 4)‐year intervals after baseline. The main analysis is restricted to those individuals with complete follow‐up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal
CVH
(cum
CVH
) was calculated as the summed
CVH
score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cum
CVH
and incident diabetes. In fully adjusted models, compared with the lowest quintile of cum
CVH
, individuals in the highest quintile had ~68% (95% confidence interval [
CI
] 60‐75) lower risk for incident diabetes (compared with 61% [95%
CI
52‐69] lower risk when using baseline
CVH
). Every additional year lived with a 1‐unit increase in ideal
CVH
was associated with a 24% (95%
CI
21‐28) reduction in incident diabetes.



Conclusions

Ideal
CVH
is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of
CVH
exposure are used. Measures of cumulative exposure to ideal
CVH
are more likely to reflect lifetime risk of diabetes and possibly other health outcomes.



Clinical Trial Registration

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